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Knot security of suture materials.
1Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison 53706.
Veterinary Surgery : VS
|July 1, 1989
Summary
Suture knot security varies by material and type. Square knots require 3-4 throws for security, while surgeon's knots offer comparable security. Granny knots are less reliable for most materials.
Area of Science:
- Biomaterials Science
- Surgical Technology
- Mechanical Engineering
Background:
- Suture security is critical for surgical success, preventing wound dehiscence.
- Different suture materials possess unique biomechanical properties influencing knot integrity.
- Understanding knot security aids in selecting appropriate materials and techniques.
Purpose of the Study:
- To biomechanically evaluate the knot security of various suture materials in vitro.
- To determine the minimum number of throws for secure knots with different suture types.
- To compare the security of square, surgeon's, and granny knots across materials.
Main Methods:
- Tested knot security of chromic gut, polyglycolic acid, polyglactin 910, polydioxanone, polypropylene, and nylon (2-0) sutures.
- Tied and incubated 20 reproducible knots per material in canine serum at 37°C for 24 hours.
- Tested knots to failure, defining security as breakage over slippage.
Main Results:
- Minimum throws for secure square knots: 3 for gut, PGA, PGLA, polypropylene; 4 for polydioxanone, nylon.
- Surgeon's knots demonstrated security comparable to square knots across all tested materials.
- Granny knots were secure only for gut, PGA, and polydioxanone; loosely tied knots showed reduced security.
Conclusions:
- Knot security is material-dependent, with specific throw counts recommended for different sutures.
- Surgeon's knots provide a secure alternative to square knots for most tested materials.
- Careful knot selection and technique are essential to ensure adequate security in surgical closures.